NUR 572 Study Guide

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Sample questions from NUR 572 Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.An inpatient nursing team proposes scheduled nighttime toileting to reduce falls among older adults. One small observational study supports the intervention, but some patients report that interrupted sleep worsens daytime fatigue. Which approach best integrates evidence-based practice, functional assessment, and quality improvement?

   • A.Implement the schedule for all older adults because any published evidence establishes the preferred standard of care.
   • B.Combine critical appraisal of the evidence with individual mobility and toileting assessments, patient preferences, and a monitored pilot measuring falls and sleep disruption.
   • C.Allow each nurse to choose a toileting schedule based only on personal experience, without collecting unit-level outcomes.
   • D.Postpone all fall-prevention interventions until a randomized trial confirms that scheduled toileting improves outcomes.

   Rationale: B integrates research quality, clinical expertise, functional needs, patient preferences, and outcome evaluation. A overstates what a small observational study establishes and ignores individual harms. C excludes systematic evidence and outcome measurement. D unnecessarily delays individualized fall prevention while awaiting stronger evidence.

2. 2.A 78-year-old patient develops confusion two days after starting an over-the-counter sleep aid containing diphenhydramine. The patient is inattentive, has fluctuating alertness, and cannot recall the last void. The family reports independent medication management and normal cognition before this illness. Which action is most appropriate?

   • A.Document probable dementia and arrange routine outpatient cognitive testing after discharge.
   • B.Administer another dose of the sleep aid to improve sleep and reassess cognition the next morning.
   • C.Treat the presentation as possible delirium, assess vital signs, oxygenation, glucose, and urinary retention, and promptly communicate the medication exposure to the prescriber.
   • D.Conclude that diphenhydramine is the sole cause and stop further assessment once the medication is discontinued.

   Rationale: C recognizes acute, fluctuating inattention as concerning for delirium and evaluates reversible contributors while addressing an anticholinergic exposure. A is inconsistent with the abrupt change from baseline. B can worsen delirium and retention. D prematurely closes the differential; infection, hypoxia, metabolic abnormalities, and other causes may coexist.

3. 3.A patient admitted with pneumonia becomes difficult to arouse. Assessment shows a respiratory rate of 32/min, oxygen saturation of 85% on room air, blood pressure of 82/46 mm Hg, and cool extremities. Lactate is 4.2 mmol/L. Which nursing response has the highest priority?

   • A.Activate the rapid response system, support airway and oxygenation, and initiate protocol-directed monitoring and sepsis interventions while preparing for higher-level care.
   • B.Obtain a complete medication and social history before notifying the clinical team.
   • C.Encourage oral fluids and reassess blood pressure and mental status in one hour.
   • D.Wait for blood culture results before escalating care or supporting oxygenation.

   Rationale: A addresses immediately life-threatening hypoxemia and circulatory compromise, with findings concerning for sepsis-associated hypoperfusion. B delays stabilization for a nonpriority history. C is inadequate for shock and risks aspiration in a patient with impaired alertness. D delays urgent treatment; cultures can guide therapy but are not required before escalation or oxygen support.

4. 4.A patient with type 1 diabetes has vomiting, abdominal pain, glucose of 486 mg/dL, elevated beta-hydroxybutyrate, venous pH of 7.18, bicarbonate of 11 mEq/L, and potassium of 2.9 mEq/L. Isotonic IV fluid replacement has begun. A continuous IV insulin infusion is prescribed. What should the nurse do next?

   • A.Start insulin immediately because correcting hyperglycemia takes priority over the potassium concentration.
   • B.Administer IV sodium bicarbonate as the primary treatment for the acidosis.
   • C.Restrict additional fluids because hyperglycemia indicates excess intravascular volume.
   • D.Hold initiation of insulin, promptly notify the prescriber, and replace potassium according to protocol with cardiac and laboratory monitoring.

   Answer and rationale are in the full material.

5. 5.An older adult with heart failure and chronic kidney disease is preparing for discharge after treatment of fluid overload. Prescriptions include furosemide and newly initiated lisinopril. During reconciliation, the patient reports taking daily ibuprofen and a potassium-containing salt substitute. The patient lives alone and has difficulty reading small print. Which discharge plan is most appropriate?

   • A.Continue all home products because nonprescription medications and dietary substitutes do not require reconciliation.
   • B.Ask the patient to stop lisinopril permanently and use ibuprofen instead whenever leg swelling occurs.
   • C.Review ibuprofen and the salt substitute with the prescriber or pharmacist, arrange timely potassium and renal function testing, and use an accessible medication plan with teach-back and individualized weight and symptom instructions.
   • D.Provide standard written instructions and advise follow-up only if severe shortness of breath develops.

   Answer and rationale are in the full material.